MS-Multiple Sclerosis clinic

Dr. Fu Ph.D. , R.Ac. Founder of Yi Acupuncture

Multiple Sclerosis (MS) is a disease of the central nervous system (CNS). The CNS is made up of the brain and spinal cord. The CNS nerves are made up of single neurons that are responsible for carrying messages from the brain. Each neuron is made up of a nucleus, dendrites, axon, cell body and a covering called the myelin sheath.

The myelin sheath protects the nerve (axon) from damage. In MS, the body’s own defences (t-cells) attack the myelin, the substance that protects the nerve fibers of the brain, optic nerves, and spinal cord.

The central nervous system (CNS) controls much of the body’s functioning and much of this activity passes through the white matter at some point. It is not surprising, therefore, that a disease which damages white matter can produce a very wide range of symptoms. Indeed, there are few diseases with more potential symptoms than multiple sclerosis.

Few of the symptoms of MS are unique to the disease and, even if you have one or more of them, it doesn’t necessarily mean that you have multiple sclerosis. However, all of these symptoms deserve medical attention and you should see a doctor if you develop any of them

Visual Symptoms
Symptom	Description
Optic Neuritis	Blurred vision, eye pain, loss of colour vision, blindness
Diplopia	Double Vision
Nystagmus	Jerky Eye Movements
Ocular Dysmetria	Constant under- or overshooting eye movements
Internuclear Ophthalmoplegia	Lack of coordination between the two eyes, nystagmus, diplopia
Movement and sound phosphenes	Flashing lights when moving eyes or in response to a sudden noise
Afferent Pupillary Defect	Abnormal pupil responses
Motor Symptoms
Symptom	Description
Paresis, Monoparesis, Paraparesis, Hemiparesis, Quadraparesis	Muscle weakness – partial or mild paralysis
Plegia, Paraplegia, Hemiplegia, Tetraplegia, Quadraplegia	Paralysis – Total or near total loss of muscle strength
Spasticity	Loss of muscle tone causing stiffness, pain and restricting free movement of affected limbs
Dysarthria	Slurred speech and related speech problems
Muscle Atrophy	Wasting of muscles due to lack of use
Spasms, Cramps	Involuntary contraction of muscles
Hypotonia, Clonus	Problems with posture
Myoclonus, Myokymia	Jerking and twitching muscles, Tics
Restless Leg Syndrome	Involuntary Leg Movements, especially bothersome at night
Footdrop	Foot drags along floor during walking
Dysfunctional Reflexes	MSRs, Babinski’s, Hoffman’s, Chaddock’s
Sensory Symptoms
Symptom	Description
Paraesthesia	Partial numbness, tingling, buzzing and vibration sensations
Anaesthesia	Complete numbness/loss of sensation
Neuralgia, Neuropathic and Neurogenic pain	Pain without apparent cause, burning, itching and electrical shock sensations
L’Hermitte’s	Electric shocks and buzzing sensations when moving head
Proprioceptive Dysfunction	Loss of awareness of location of body parts
Trigeminal Neuralgia	Facial pain
Coordination and Balance Symptoms
Symptom	Description
Ataxia	Loss of coordination
Intention tremor	Shaking when performing fine movements
Dysmetria	Constant under- or overshooting limb movements
Vestibular Ataxia	Abnormal balance function in the inner ear
Vertigo	Nausea/vomitting/sensitivity to travel sickness from vestibular ataxia
Speech Ataxia	Problems coordinating speech, stuttering
Dystonia	Slow limb position feedback
Dysdiadochokinesia	Loss of ability to produce rapidly alternating movements, for example to move to a rhythm
Bowel, Bladder and Sexual Symptoms
Symptom	Description
Frequent Micturation, Bladder Spasticity	Urinary urgency and incontinence
Flaccid Bladder, Detrusor-Sphincter Dyssynergia	Urinary hesitancy and retention
Erectile Dysfunction	Male and female impotence
Anorgasmy	Inability to achieve orgasm
Retrograde ejaculation	Ejaculating into the bladder
Frigidity	Inability to become sexually aroused
Constipation	Infrequent or irregular bowel movements
Fecal Urgency	Bowel urgency
Fecal Incontinence	Bowel incontinence
Cognitive Symptoms
Symptom	Description
Depression
Cognitive dysfunction	Short-term and long-term memory problems, forgetfulness, slow word recall
Dementia
Mood swings, emotional lability, euphoria
Bipolar syndrome
Anxiety
Aphasia, Dysphasia	Impairments to speech comprehension and production
Other Symptoms
Symptom	Description
Fatigue
Uhthoff’s Symptom	Increase in severity of symptoms with heat
Gastroesophageal Reflux	Acid reflux
	Impaired sense of taste and smell
	Epileptic seizures
	Swallowing problems
	Respiratory problems
Sleeping Disorders	Inappropriately cold body parts
	Autonomic nervous system problems

TREATMENT STRATEGIES

To resolve MS, a current Western medical approach is to find a protein that will block the autoimmune attack, thereby stopping any further demyelination, and thus preventing further development of MS. Another is to apply a peptide (cytokine, a small protein, such as interferon) that regulates immune responses and controls initiating viruses, thus reducing the number of MS attacks. There are numerous other methods being investigated, in which something is introduced into the body to interfere with the autoimmune process. The Chinese medical approach is also to introduce something into the body, with the aim of replenishing body essence and to rehabilitate internal organ functions, through diet and herbs, rather than products of advanced technology. Acupuncture is applied in an effort to rectify the circulatory disturbances that arise from the disharmony of organ functions; the improved circulation helps the organs and tissues return to a normal, healthy condition. Further, steps to resolve underlying spiritual and emotional distresses are undertaken on the basis of discussions and recommendations.

The herb combinations prescribed by doctors of Chinese medicine are selected on the basis of past experience with treating “flaccidity syndromes” (mostly diseases other than MS that cause muscular weakening) and on the basis of the current health status of the individual. The latter is to be established by asking questions and conducting some traditional diagnostic procedures, such as analyzing the appearance of the tongue and feeling of the pulse at the wrist. Not only do the symptoms of MS vary from individual to individual, but also the health histories (such as coexisting diseases or syndromes) are different, and these factors must be accounted for in determining suitable prescriptions. Acupuncture treatments are likewise selected on the basis of previous experience with other patients, such as those who experience paralysis due to stroke, and on the basis of unique characteristics of the individual currently under treatment. Thus, there is not a single remedy for MS that can be offered through the traditional Chinese medical approach, but rather a composite treatment based on individual needs.

According to a published clinical trial and a small number of individual case reports from China, MS symptoms can be effectively controlled in many patients by consistent use of Chinese herb formulas. To attain a successful outcome, the correct herb prescription for the individual’s unique needs must be selected, the dosage must be adequate, and the duration of treatment must be long enough so that beneficial results persist once the therapy has been completed.

The duration of therapy for MS patients reported in Chinese studies ranges from two months to over two years; herbs used to prevent exacerbations might be taken for several more years. If the herbs are discontinued after the initial treatment period, some patients may remain free of symptoms for many years. In some cases, there can be a relapse, but prompt resumption of herb use will help the individual regain freedom from disease symptoms for a period of time. Despite the long duration of therapy necessary in some cases, it is not uncommon in China for improvements to be noted within the first two months.

Improvements to be expected include an enhancement in one’s overall sense of well-being, a reduction in the severity of persisting symptoms, a reduction in the use of drugs that control symptoms, including antidepressant drugs, and a reduction in the incidence of bouts of weakness. In some cases (perhaps 20%), the individual will apparently be cured.

In a Chinese study [1] with 35 patients, four different herb formulas were developed. People were treated according to the diagnosis that would place each into one of the four broad diagnostic categories that matched the herb therapeutics. The complex herb formulas were prepared as decoctions (tea made by boiling the herbs for about 45 minutes) using 8 to 15 grams of each ingredient (a total of about 150 grams per day), consumed as a cooling drink (rather than hot, as many MS patients have an aversion to heat). Anti-inflammatory Western drugs were given during acute active periods of the disease. Except for three patients that discontinued treatment within the first ten days, some improvement was found in all who tried this method. Two cases were deemed basically cured after taking just 45 and 68 doses; 15 were markedly improved, and another 15 somewhat improved—most of them taking 20 to 40 doses. Eleven of the patients had tried corticosteroids unsuccessfully before switching to the traditional herb combinations; of these, 7 were markedly improved, 3 improved, and only 1 failed to respond.

The same researchers then conducted a study [2] of prevention of exacerbations. 30 MS patients (15 male and 15 female) were given an herbal formula, called Ping Fu Tang, comprised of 17 herbs. Each herb was used in a dosage of 8–15 grams (except two auxiliary herbs used in low dosage), with a total daily dosage of about 150–180 grams of herbs in decoction. The herbs were taken in two to three divided doses each day. The patients took these herbs for a period of 3 to 13 years (average of 6 years) and during this period, only two mild exacerbations occurred in the group. By contrast, a control group of 15 MS patients had an exacerbation rate of 1–4 times per year.

Two case studies of MS treatments were reported [3] from the work of Dr. Domei Yakazu in Japan. Good therapeutic results were described from the regular ingestion of an herb formula over a period of two and a half years in a man aged 48, and marked improvement was noted in a woman, aged 34, who consumed two traditional formulas for a period of approximately two months. According to a translated report from China [4], a female patient, aged 38, was treated with herb decoctions for about 15 weeks and was then given herb pills to take regularly for one year. The clinicians reported that she was cured as a result of the treatment. A general survey of Chinese journals shows that there are a small number of other similar reports, each article describing one or two patients treated with obvious benefit.

The dosages of herbs used in Chinese clinical studies that have demonstrated successful resolution of MS, and other chronic diseases, tend to be quite high. Longer-term therapy with lower dosage, as used in Japan, has been reported to produce good results, but no claims of cures, as yet. Because Americans are not used to relying on herb remedies, the dosage applied in China may seem exceptionally high when compared with ingestion of drugs, vitamins, or even herb remedies that are administered for less serious disorders. Chinese herbs may be provided in bulk form to make a strong decoction, or by spoonfuls of powdered herb or extracts. If the herbs are taken in pill or tablet form, the number of them to be ingested might be quite high (e.g., 24 large tablets per day).

While the herb compounds used in treating MS are nontoxic, it is possible to experience some reactions. The most likely adverse response is a gastro-intestinal reaction that might include indigestion, loss of appetite, nausea, vomiting, diarrhea, flatulence and bloating. Such reactions can usually, but not always, be eliminated by changing the time of taking the herbs in relation to meals, by providing a digestion-promoting formula (or a simple ginger tea) to be taken at the same time, or by using a different prescription. In a very small number of cases, an allergy-like reaction may arise, and this usually manifests early in the treatment with a rash which will be alleviated when the use of those particular herbs ceases, but will quickly reappear if the same herbs are taken again.

If herb therapy is the primary method of treatment and if there are no special difficulties encountered (e.g., no need for frequent changes in prescription), an office visit every two to three months may be adequate once a treatment program has been established. If acupuncture is pursued as an additional therapy, treatments might be undertaken at the rate of three to four times per month (more frequently following an exacerbation of MS). An acupuncture procedure known as scalp acupuncture appears to provide the best results. A specialist in this type of acupuncture, Mingqing Zhu, works at the Chinese Scalp Acupuncture Center in San Francisco. He has written a book about his techniques [5], which is available from the Center, and has personally trained many American acupuncturists in its use (practitioners can also learn many of the techniques from his book).

In addition to the traditional Chinese techniques, nutritional interventions may be suggested; these are based on Western research, but have been adopted as part of natural medicine in modern China. For example, studies have shown that some individuals with MS have low blood levels of vitamin B₁₂, a nutrient which is essential to myelin sheath repair (it may be necessary to give this nutrient by injection, since poor intestinal absorption may be the reason for low blood levels). Calcium supplements can be especially important to women suffering from MS, since any reduced mobility from the disorder can lead to increased risk of osteoporosis. Magnesium supplements could be helpful in reducing spasms, which are a problem for some persons with MS. Dietary modifications, to remove allergens and to adjust the fat content (to very low levels), have been reported as helpful in some patients.

At ITM’s An Hao Natural Health Care Clinic in Portland, Oregon, about 45 MS patients have undertaken treatment with Chinese herbs, nutritional supplements, and acupuncture during the past eight years, most of them carefully monitored during 1994–1996 as part of a study partially funded by gifts from the MS Foundation of Fort Lauderdale, Florida. Using the protocols at the An Hao Clinic, including scalp acupuncture, as long as the treatments are pursued regularly, there is relief of many symptoms (including urinary disorders and constipation), less use of certain drugs (notably antidepressants), and reduction or elimination of attacks of muscular weakening and incoordination. Adverse reactions to the standard herb formulas have not been a problem with this relatively small group, but a number of patients were unwilling to take the large amounts of herbs recommended.

We do not know, at this time, to what extent it is possible to reverse neurological damage that leads to a person being wheelchair bound. At our clinic, several persons with MS who use walking aids (such as canes or walkers) have been able to eliminate the need for these devices as the result of acupuncture treatments, especially the scalp acupuncture that has previously been used by Dr. Zhu to successfully treat paralysis due to stroke. One person with MS who was wheelchair bound was able to begin standing and walking with the assistance of a walker, but still uses the wheelchair much of the time. The outcome depends on the nature and extent of the nerve damage that has occurred, and on the willingness and ability of the person to attempt the physical therapies to restore mobility. If there remains some limited ability to walk when acupuncture and herb therapy are initiated, then it is very likely that the individual can be coaxed into a greater mobility.

Irregularity in using Chinese medical therapies (infrequent acupuncture, missing daily doses of herbs) appears to be the main reason for poor results among those with the relapsing/recovering type of MS. With MS, as with many other chronic diseases, some individuals who try the Chinese medical approach stop using it before it can have a marked effect. This drop-out from treatment may be due to inconvenient access to the clinical site, unwillingness to take the herbs and supplements regularly, or disappointment if there is not prompt, dramatic, and sustained benefit. Few participants, regardless of their enthusiasm for the method, were able to come to the clinic for twice-per-week acupuncture, during the first 2–3 months of treatment, as would be preferred from the practitioner’s point of view.

Since sclerosing is a cumulative process, effective control of the disease over an extended period of time can also prevent the worsening of symptoms that occurs when large areas of nerve fibers are damaged. For many chronic diseases, Western medicine offers a control of symptoms through life-long administration of a synthetic drug. Substituting a life-long application of Chinese herb formulas may produce comparable results, while avoiding some of the side-effects typically associated with the chemical isolates that comprise pharmaceutical products. More importantly, the Chinese medical therapies aimed at relieving the MS can help treat other health problems at the same time.

TCM differentiation and treatment:

1. Phlegm and heat accumulation

Clear the heat and resolve the phlegm, and then open meridians

Formula: Di Tan Tang.

Indication: for speech difficulty, dizziness, limb numbness.

2. Damp and heat accumulation

Clear the heat and dring damp

Formula: Er Miao Tang

Indication: weakness of lower limbs from damp heat dropping and accumulation

3. Stasis and stagnation in meridian

Open meridian and remove stasis

Formula: Sheng Yu Tang

Indication: chronic MS, tiredness, weakness in lower limbs.

4. Deficiency

a. Lung and spleen qi deficiency

Tonify lung and spleen qi

Formula: Shen Ling Bai Zhu San

b. liver and kidney deficiency

Formula: Zhuo Gui Yin

c. kidney yang deficiency

formula: You Gui Yin

Acupuncture treatment for MS

Advantage of acupuncture:

MS is considered as essence deficiency and stagnation in meridians. To open the blockage and remove the stagnation, acupuncture should be one of the best techniques. As long as the meridian is reopened, the symptoms will be relieved; lots of acupuncture researches have shown with acupuncture treatment, the episode is significantly decreased and course of disease is shortened.

Other researches show: most of chronic MS patients have essence deficiency. TCM considers it as yang qi deficiency. If practitioners combine with moxa, some special techniques for activating yang in regular acupuncture treatment, the result is much better than western medicine.

Common points for MS: Du20, ST8, GB8, UB10, H7, GB20, UB15, 18, 20, 23, GB30, SP6, K3

Paralysis in arm: LI11, 15, 10, 4; SJ5

Paralysis in leg: ST31, GB31, GB34, SP6, GB39

Difficulty in speech: R23, LI4, H5, DU15

Difficulty in swallow: R23, LI18, GB20, LI4

Urine retention: R4, 6, 3, UB23

Urine incontinence: R3, 4, 6

Constipation: ST36, GB34, ST25, ST37, R12

for more detail, please contact Dr. Fu or visit www.uhealing.com